Do You Use Capsular Tension Rings During Cataract Surgery?
March 10, 2009
I’ve never used these before (I’m not a high volume surgeon), and the videos make me cringe a little. I notice that the insertion puts a fair amount of stress on the zonules. But I understand that despite that, surgeons swear by them, so I know that they work. Probably, in a pretty dense cataract with bad zonules, I am going to refer the case- it’s not worth the grey hairs! But in a moderate cataract, I feel comfortable trying it out. I wonder what other lower-volume surgeons like me think.
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2 Responses to “Do You Use Capsular Tension Rings During Cataract Surgery?”
thanks dr. richardson. i also read about new ctr’s that have like a corrugated profile so that it is easier to remove cortex- have you tried that one?
I would consider myself a moderate-volume surgeon (about 300 cases/yr) and shared your concern about capsular tension rings prior to my first implantation. The thought that first went through my mind was “holy cow, that thing is going to go right through the bag or tear the remaining zonules.” After a few implantations, however, you get used to the insertion process and appreciate how much smoother the rest of the case goes with the additional capsular support.
However, the real challenge is not the implantation but the removal of the cortical fibers once a CTR is in place. I’ve found that a bi-manual I&A set makes a big difference when a CTR is pinning the cortex against the bag. Additionally, you can try to “walk” the cortex along the CTR to the ends of the ring where it will be free of the CTR compression. Patience is also a real virtue.
Sincerely,
David D. Richardson, M.D.
Medical Director
San Gabriel Valley Eye Associates, Inc.
LA and So Cal’s Trusted Source of Eyecare
207 S. Santa Anita Street, Suite P-25
San Gabriel, CA 91776
626.289.7856
